Evaluation of Training of Health Workers in Brief Motivational Interviewing in the Developing World: A South African Example

Background: The present study was developed to assess the ability of health workers in antiretroviral clinics in South Africa, to learn and apply Motivational Interviewing (MI) during HIV/AIDS patient care sessions. It was hypothesized that after completion of an 8 hour MI training workshop and one feedback/coaching session: (1) Health workers would employ more MI strategies in their interactions with patients compared to their standard of care; and (2) Health workers would reach MI beginning proficiency as measured by the Motivational Interviewing Treatment Integrity code (MITI).

Methods: Twenty four health workers were recruited from five rural public antiretroviral clinics. Audio-tape recordings were obtained of health workers during actual patient sessions. The study was conducted in three phases: (1) baseline data-collection; (2) MI training intervention of health workers; and (3) post- intervention data collection. Paired t-tests and one-sample t-tests were performed to test hypotheses.

Results: Results from this study showed no significant differences between first baseline scores and first feedback/coaching scores, and between mean baseline scores and first mean feedback/coaching scores. Overall participants scored significantly lower than MITI beginning proficiency thresholds. Qualitative analysis of MITI trends indicate that with three cycles of feedback and coaching health workers could reach beginning proficiency in MI.

Conclusion Further research in the training of health workers in MI, should contemplate 4-5 feedback/coaching cycles to ensure beginning proficiency. Given the desire of participants to be in the study, this study illustrates that the training of health workers in MI is a feasible endeavor.